Terms & Conditions (Terms of Use)

Terms and Conditions of VirtualMD 360, P.A., hereby referred to as VirtualMD 360

· I understand that completing a consultation form on behalf of anyone other than myself, unless completing a form for my dependent children under the age of 18, violates VirtualMD 360’s privacy policy. 

· I understand that I am engaging in a telemedicine consultation with a licensed VirtualMD 360 physician. 

· I authorize VirtualMD 360, P.A.’s contracted physicians to provide me with their observations and treatment recommendations regarding my medical condition using telemedicine.

· I understand that a VirtualMD 360, P.A. contracted physician wishes to engage with me in a telemedicine consultation using VirtualMDHealth.com telemedicine platform.

· I understand that the use of telemedicine involves the electronic communication of my protected health information. I understand that VirtualMDHealth.com is a telehealth platform used by physicians of VirtualMD 360, P.A. and that VirtualMD Health, LLC is headquartered in Georgia.

· I understand that contracted physicians of VirtualMD 360, P.A. will not perform an in-person physical examination during the telemedicine consultation. They will exclusively rely on the information telecommunicated during the telemedicine consultation.

· I understand that telemedicine consultations carry the risk of delayed diagnosis or misdiagnosis. I understand that physical signs and symptoms that might be detected by a physician during an in-person consultation/visit may not be detected through a telemedicine visit, which could lead to me not receiving the proper treatment or even receiving the wrong treatment. I understand these potential risks and am willing to proceed with consultation with a VirtualMD 360 physician. I understand these potential risks, accept the risk of misdiagnoses or delayed diagnoses, and am willing to proceed with consultation with a VirtualMD 360 physician.

· Due to the potential risk of delayed diagnoses or misdiagnosis, I understand and agree to seek immediate medical attention if my symptoms worsen or if my symptoms do not improve within 48 -72 hours. 

· I understand that the treatment and recommendations provided by my VirtualMD 360 physician is an initial treatment approach, and I agree to follow-up with a physician within the next 3-4 days for a reassessment. 

· I understand that I have the option of seeing another physician for an in-person visit who could evaluate me and provide me with treatment recommendations. I understand and accept the potential risks of misdiagnoses or delayed diagnoses with a telemedicine visit and I am willing to proceed with consultation with a VirtualMD 360 physician.

· I understand how the videoconferencing technology used to provide a telemedicine consultation will not be the same as an in-person patient-physician visit since I will not be in the same room as the physician. 

· I understand there are potential risks to this telemedicine technology, including but not limited to: visit interruptions, loss of medical records from electronic equipment failure, unauthorized access including outside invasion of records by hackers, and technical difficulties including power failure, audio trouble, and/or video trouble. I understand that my physician or I can discontinue the telemedicine consult/visit if it is felt that the videoconferencing connections are not adequate for the visit to continue.

· I understand that telemedicine is the use of electronic information and communication technologies by a healthcare professional to deliver services to an patient who is located at a different site than the healthcare professional; and I hereby consent to have a VirtualMD 360 physician to provide healthcare services to me via telemedicine. 

· I hereby consent to and authorize VirtualMD 360 physicians to administer and perform medical evaluation and treatment deemed necessary and appropriate, and I release VirtualMD360.com and VirtualMDHealth.com of any legal responsibility.

· I understand that electronic communication technology will be used during my online visit consultation and that an online visit consultation is not the same as an in-person physician visit since I will not be in the same room as my physician.

· I understand that my personal healthcare information may be shared with VirtualMD 360’s medical team (MDs, DOs, PAs, NPs, Nurses, Medical Assistants, Medical Office Assistants, and Patient Care Specialists) for purposes such as scheduling, billing, prescribing, or any other relevant medical functions. The VirtualMD 360’s medical team are required to maintain confidentiality of all medical information obtained.

· I understand that the VirtualMD 360 physician or I can discontinue the telemedicine consult visit if it is decided that the electronic communication technology is not adequate for the visit to continue. 

· I understand that I have the right to withdraw my consent to the use of telemedicine at any time during care. If my telemedicine consent is still in effect, VirtualMD 360 physicians may provide healthcare services to me via telemedicine without the need to sign another consent form. 

· I have explored other alternatives to a telemedicine consultation, and I am choosing to participate in a telemedicine consultation with a Virtual MD 360 physician. I understand that some parts of my physical examination may be limited because I will not be in the same room as my physician. 

· I accept VirtualMD 360’s model of telemedicine and I have visited VirtualMD360.com and VirtualMDHealth.com to learn how this model works and the scope of practice of VirtualMD 360’s physicians. 

· By choosing to participate in a telemedicine consultation with a VirtualMD 360 physician, I understand that physical tests are not able to be performed or ordered by my telemedicine physician. 

· I accept that the observations and recommendations of the VirtualMD 360 physician are limited in scope and nature to the specific issues discussed during the telemedicine consultation visit.

· I acknowledge that I may contact VirtualMD 360 via email or phone with questions or concerns at 800-528-7045 or at Info@VirtualMD360.com.

· By continuing to use VirtualMD360.com and by using the telemedicine services of VirtualMD 360 physicians on VirtualMD360.com or the VirtualMDHealth.com telemedicine platform, I certify: 

1. That I am establishing a Physician-patient relationship via telemedicine and/or telehealth. 

2. That I have read or had this Terms & Conditions read and/or explained to me in a way that I fully understand the information provided.

3. That I fully understand the contents of this Terms & Conditions including the risks and benefits of telemedicine. 

4. That I have been given ample opportunity to ask questions and that any questions have been answered to my satisfaction in a language in which I understand. 

5. That I agree with all information contained within this Terms & Conditions. 

6. That I consent to receiving the telemedicine and/or telehealth services described above, if I choose to engage in telemedicine services provided by VirtualMD 360’s physicians. 

7. I understand that I have the following rights as it relates to the telemedicine services provided by the contracted physicians of VirtualMD 360, P.A.: 

a. Confidentiality. The laws that protect the confidentiality of medical information apply to telemedicine, and no identifying information or images from the telemedicine interaction will be disclosed to other parties without my consent, except as permitted by law. 

b. Right to withdraw consent. I have the right to withdraw or withhold my consent to telemedicine at any time and this does not affect my future right to healthcare or treatment.

c. Access to information. I have the right to inspect all medical information obtained during my telemedicine consultation and may receive copies of this information if requested. 

8. That I accept this Terms & Conditions. 

Adopted April 21, 2020